A Program Project, MANAGEMENT OF CHRONIC PAIN IN REHABILITATION,is proposed to initiate a systemic program of multidisciplinary research investigating the nature, scope, and management of chronic pain problems in individuals with spinal cord injury, amputation, and cerebral palsy. The specific aims of the Program Project are: 1. (a) To determine the frequency and types of chronic pain experienced by persons after spinal cord injury; and (b) to examine the efficacy of specific a pharmacological treatment (oral amitriptyline) compared to placebo in reducing pain and disability and improving functional capacity in persons with spinal cord injury (Project I). 2. (a) To determine the prevalence and types of chronic pain experience by persons with cerebral palsy; and (b) to examine the associations between specific pain coping responses and subsequent pain and functioning in individuals with cerebral palsy (Project II). 3. (a) To examine the efficacy of pre-amputation analgesia on the incidence of phantom limb and stump pain following amputation; (b) to determine the frequency and types of chronic pain experienced by persons with acquired amputation: and (c) to examine the efficacy of a specific pharmacological treatment (oral amitriptyline) compared to placebo in reducing pain and disability and improving functional capacity in persons with chronic pain associated with amputation (Project III). 4. In support of these research, a scientific core will provide centralized support services for scientific communication, statistical consultation, data management, measure development, and preparation of reports and manuscripts. The scientific core will also examine and refine a biopsychosocial model of chronic pain as it applies to individuals with physical disabilities both within and across each study group. Scientific Core personnel will also perform interviews with select study participants to determine: (1) the qualitative nature of chronic pain problems for specific individuals, (2) the effects of pain on the participants' lives, and (3) the impact of the interventions on each individual's life. This broad-based research project will enhance our understanding of the chronic pain problems in individuals with physical disabilities, and will also, for the first time, provide examinations of pain treatment interventions that have been recommended for the treatment of these pain problems.